Near mid-air collision report



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Date02.02.2017
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#15681
TypeReport
HT-18

NEAR MID-AIR COLLISION REPORT

(1 MAY 87)

(COMPLETE AND RETURN TO ASO ASAP)
REPORT CONTENT:
(FILL IN AS MUCH AS POSSIBLE)


  1. DATE, TIME, DAWN, DAY, DUSK, NIGHT.




  1. LOCATION.




  1. MODEL/BUNO REPORTING A/C, DEST.




  1. MODEL OF OTHER A/C, DEST, COLOR.




  1. TYPE OF FLIGHT PLAN, ALTIMETER SETTING.




  1. DETAILED WX CONDITIONS A/C ALTITUDE.




  1. APPROX COURSE OF EACH AIRCRAFT.




  1. SEPARATION DISTANCE AT FIRST SIGHTING CLOSEST POINT.




  1. DEGREE OF EVASIVE ACTION TAKEN/INJURIES.



  2. IFF CODE




  1. PILOT'S NAME

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